6-Days Out of DaVinci --- Catheter Out and Great News

I went for my post-op today.  They did the blood work and a Cystography to make sure there were no leaks in the system.  Afterwards, I met with the PA (Dr. behind shedule not available) and the PA gave me the great news.

Bilateral nerve sparing surgery, both sides spared

Post-op Stage T2a N0 M0  involving 1/2 of one side or less

pN0 28 lymph nodes removed and no lymph node involvement

No seminal vesel involvement

Gleason 3+4 = 7

Margins intact and no positive margins

Tumor size 1% of total prostate pT2a

In other words, the surgeon delivered.  Cannot be better.  Catheter removed and (cross my fingers) I can start and stop and control.  So far I am dry.  Only thing left is a small draining bag in one of the incisions and lots of abdominal and scrotum swelling.  Next appointment in a month to check PSA.

Thank you David. Glad to leave the snake behind.

Sounds good! Now just stay dry.

Congratulations! Looks like an outstanding result. That is an impressive number of lymph nodes! I am trying to recall if I ever heard of anyone else having 28 removed. I had 14 removed and that seemed like a lot at the time.

This is as good a report as anyone could hope to get. The amount of cancer is small but with a 3+4 it had to get treated. Margin status is great and you are continent from the get go. Congratulations!!!

An

KRM. Outstanding report! OK, just a preemptive strike here. With that many lymph nodes dissected, the pratt drain may be there awhile. Mine was in for 5 weeks. Listen to your surgeons instructions carefully on this. I was told that when the out put drops below 50 cc, its time to come out, but if it doesn;t come out within 24 hrs of that, it will start to increase again. Mine came close to 50 it was a weekend but because it was not below the magic # and the nurse was off, It was not removed, it increased. My surgeon/ urological oncologist Bruce Dalkin had me wait a little longer and when it didn't decrease, he simply took the tube out , replaced it with a smaller, circumference wise, tube. Within 24 hrs, like a fawcet was tuned off, it stopped. As we had instructions on how to remove it our selves, my wife, who has no medical tng did it. Ok the story isnt quite over so I am going to post this and edit so I have more room. I always use the quick reply then run out of room, good memory, just short, tee hee, standby one.... Hokay, here we go. about 8 weeks post op I had a low grade fever for 3 weeks. Lymphocele's google it. I had 2 the size of golf balls,CT scan, they normaly self resolve in a month or so, mine did. If they dont, they are medically drained easily. You may not get them, not all with lymph node dissection do. I had 29 nodes removed, the more you have removed, the higher the chances you will, tho. Just a heads up. My sugeon never told me of possibility, and I understand that, he said 20% of patients will get them. You are doing great!!! Aloha, Logo

Thanks guys. Logo, thanks for the heads up. The draining was a surprise. However, they did not put a pratt drain in me. All they did is glue a small bag around the draining incision to collect the fluid. When the bag fills up, I go and empty it. The rate of filling for me depends on activity and it is also heavier when I eat and lighter at night. I will definitively watch out for the signs you mention. Thanks again.

KRM -
- congrats on the good path report -
-you can help the swelling of the scrotum by reclining and keeping your legs and feet up (on a pillow or such)
-wishing you all the best for a steady and boring recovery

Bronson

p.s. p-elliot is referring to Lymphedema -a buildup of lymphatic fluid that is not drained away - (that is why your balls are temporarily larger than normal)

-from this particular article - risk factor is 1 in 5... (women and breast cancer - from other research)
www.hrpca.org/lymphedema.htm
-I would not worry about it all.
-the same thing can happen with regular surgery - due to my leg surgery - one leg is bigger than the other and swells up temporarily depending on my work schedule -

Post Edited (tatt2man) : 11/2/2011 2:58:27 PM (GMT-6)

Great pathology and all very similar to mine but my tumor volume was 60%. My surgeon didn't see any reason during my surgery to remove any of the lymph nodes and after hearing the drain tube stories I am glad he didn't now.  Keep up the great recovery and just because you may feel really good do not over do things for at least another week or two.

Terry

Ozbob, Dr. did not mention any side effects. However, four days out of surgery I started draining heavy from one of the incisions. Went back to the hospital and they "glued" a small drain bag with an opening to cover the incision. The bag fills out in about two hours requiring constant emptying. When I went to have the catheter out I asked about this issue and was told that it was not uncommon after lyph node removal and that it should stop in about four weeks. Seems to be a common issue until the body learns how to get rid of the unwanted fluids it generates. So much for full disclosure and informed consent.

outstanding. Great news. Fatigue still hasn't gone away for me.

I may be wrong but lymphedema occurs primarily in node removal with breast cancer, not Prostate cancer and believe it to be irreversible. Not saying it can't happen, just primarily breast cancer. On the up side, there are studies, I don,t know which ones, that say chances of recurrence are reduced by lymph node dissection, up to 30%. I read that on this forum, the study even broke it down, roughly, by giving a ratio of node removal to percent of recurrence reduction. If the poster who had that/those studies, reads this , it could be coraborrated that way or it could be googled. Using a cost/benefit analysis, Your surgeon and mine and others, went for the gusto. I also believe, it happens with aggressive, surgeons, who have a big staff under them, such as in a teaching hospital, Like U of Washington. Oh yes I have no doubts, students dissected those nodes, and more. I also have no doubt that Bruce Dalkin opened me, dissected the prostate, spared the left nerve bundle and stitched the urethra back in a magnificent performance, then closed me up. With the students doing a lot of the other kine stuff. BTW , when you are flying, the majority of time you are being controlled by a trainee, with a full performance level controller plugged in ready to step in. but as is the norm for me, I digress......